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Published on: June 13, 2025
[Diurnal changes in blood pressure and their consequences]
1International Medical Services, Kardiológia, Budapest.
Insights
Circadian rhythm influences daily blood pressure and heart rate, increasing risks for stroke and sudden death, especially in the morning. Effective antihypertensive drugs manage blood pressure fluctuations throughout the day.
Area of Science:
- Cardiology
- Chronobiology
- Hypertension Research
Context:
- Circadian rhythms significantly impact cardiovascular health.
- Hypertension and ischemic heart disease patients exhibit dangerous daily blood pressure and heart rate alterations.
- Morning hours represent a critical period for adverse cardiovascular events.
Purpose:
- To analyze daily blood pressure and heart rate variations linked to circadian rhythms.
- To investigate the association between these variations and severe clinical outcomes.
- To highlight the role of sympathetic nervous system overactivity.
Summary:
- Daily blood pressure variability and decreased heart rate variability, including loss of nocturnal dipping, are linked to sympathetic overactivity.
- Sudden blood pressure surges at any time of day pose serious risks.
- High through/peak ratio indicates effective 24-hour blood pressure control by antihypertensive medication.
Impact:
- Understanding circadian influences can optimize hypertension management.
- Continuous blood pressure control is crucial for preventing cardiovascular events.
- This research emphasizes the importance of consistent antihypertensive drug efficacy.
Abstract:
Author analyses the daily blood pressure and heart rate alterations due to circadian rhythm and their effects to development of dangerous clinical situations (sudden death, stroke, myocardial infarct, ischaemic episodes) in hypertension with or without ischemic heart disease. The most dangerous time-period is the morning hours, but serious problems are the sudden increases in blood pressure in any time of day as well. The daily changes in blood pressure (rise in blood pressure variability) are often associated with the alteration in heart rate (decrease in heart rate variability) and loss of dipp at night. The main cause of this "death-three" is the overactivity of the sympathetic nervous system. An antihypertensive drug with good quality can be capable to depress the high blood pressure continuously during the whole day inhibiting the rapid rise periods of blood pressure. The best measure of this effect is the high through/peak ratio.
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